Mechanical Valve Replacement: Early Results

Year 2012, Volume: 37 Issue: 1, 49 - 54, 01.03.2012

Habib Çakır Hasan Uncu Funda Tor Gürdeniz Yıldız Ali Hacı Uçak İbrahim Özsöyler

Abstract

Aim: Valve diseases in developing countries like Turkey which often occur as a complication of rheumatic fever are a serious disease. Surgical treatment of valve diseases should be done before irreversible damage to the myocardium occurred. In this study, we aimed to present the early results of mechanical valve replacement operations. Method: A hundred patients with mechanical valve replacement surgery were retrospectively evaluated in Seyhan Application Center attached to our clinic between July 2007 and August 2011. Results: Fifty patients were male and 50 were women. The mean age of patients was 47.88 (18-78). Isolated aortic valve replacement (AVR) was performed to 23 patients, isolated mitral valve replacement (MVR) was 32, double valve replacement (AVR + MVR) was 12, MVR + aortic valve valvuloplasty was 1, AVR + mitral kommissürotomi was 1, AVR + coronary artery bypass graft surgery (CABG) was 17, MVR + CABG was 8, MVR + atrial septal defect closure was 2 and Bentall procedure.was 4 patients. In addition, ablation procedure was performed to 5 patients intraoperatively because of preoperative atrial fibrillation. Two patients (2 %) died in early postoperative period. Conclusion: Mechanical prosthetic valves are used for surgical treatment of valve disease with low mortality and morbidity in a large group of patients like women that not to think to get pregnant, non advanced age group and patients have less risky for anticoagulation drug in our clinic.

Keywords

Mechanical Prosthesis Heart Valve, Rheumatic Heart Disease

Mekanik Kapak Replasmanları: Erken Dönem Sonuçlarımız

Abstract

Amaç: Ülkemiz gibi gelişmekte olan ülkelerde kapak hastalıkları, çoğunlukla romatizmal ateş hastalığının ciddi bir komplikasyonu olarak ortaya çıkmaktadır. Kapak hastalıklarında cerrahi tedavi, miyokardda geri dönülmez hasar oluşmadan yapılmalıdır. Biz bu çalışmamızda, kliniğimizde yaptığımız mekanik kapak replasmanı operasyonlarının erken dönem sonuçlarını sunmayı amaçladık. Yöntem: Kliniğimize bağlı Seyhan Uygulama Merkezinde Temmuz 2007-Ağustos 2011 arasında mekanik kapak replasmanı operasyonu olan 100 hasta retrospektif olarak değerlendirildi. Bulgular: Hastaların 50 tanesi erkek, 50 tanesi kadın ve yaş ortalaması 47.88 (18-78) idi. Hastalardan 23 tanesine izole aort kapak replasmanı (AVR), 32 tanesine izole mitral kapak replasmanı (MVR), 12 tanesine çift kapak replasmanı (AVR+MVR), 1 tanesine MVR+aort kapak valvuloplasti, 1 hastaya AVR+mitral kommissürotomi, 17 tanesine AVR+koroner arter bypass greft cerrahisi (CABG), 8 tanesine MVR+CABG, 2 tanesine MVR+atriyal septal defekt kapatılması operasyonu ve 4 tanesine bentall prosedürü operasyonu uygulandı. Beş hastaya preoperatif atriyal fibrilasyon nedeniyle intraoperatif ablasyon işlemi uygulandı. Postoperatif erken dönemde 2 olgu (%2) kaybedildi. Sonuç: Antikoagülasyonun az riskli olduğu ileri olmayan yaş grubunda veya gebelik düşünmeyen kadınlarda mekanik protez kapaklar, kliniğimizde düşük mortalite ve morbidite ile kullanılmaktadır.

Keywords

Mekanik protez kalp kapağı; romatizmal kalp hastalığı

References

• Oto O, Metin K. [Surgical treatment of mitral valve diseases.] Duran E (Editör). Kalp ve damar cerrahisi. Birinci baskı. İstanbul: Çapa Tıp Kitabevi; 2004; 1193-202.
• Telli A, İslamoğlu F, Uç H. [Surgical treatment of
• aortic valve disases.] Duran E (Editör). Kalp ve damar cerrahisi. Birinci baskı. İstanbul: Çapa Tıp Kitabevi. 2004; 1183-192.
• İşkesen İ. [Cardiac valve prosthesis.] Duran E
• (Editör). Kalp ve damar cerrahisi. Birinci baskı. İstanbul: Çapa Tıp Kitabevi. 2004; 1245-318.
• Belgi A, Çetin S, Altekin ER, Kalaycı B, Yalçınkaya S,
• Kabukçu M et al. [Hemodynamic performance of mechanical aortic prosthesis in the cases with small aortic annulus.] Anadolu Kardiyol Derg. 2005; 5: 30- 3.
• Gürbüz A, Akel S, Işık Ö, İpek G, Dikmengil M, Sezer
• H et al. [Mitral valve replacement with mechanical prosthesis: Midterm results.] Türk Göğüs Kalp Damar Cer Derg. 1994; 2:16-9.
• Kiriş İ, Okutan H, Peker O, Yavuz T, Öcal A, İbrişim E ve ark. [Comparison of the hemodynamic performances of Carbomedics® and On-X® bileaflet mechanical heart valves in mitral position.] Türk Göğüs Kalp Damar Cer Derg. 2006; 4:277-81.
• Ibrahim M, O’Kane H, Cleland J, Gladstone D,
• Sarsam M, Patterson C. The St Jude Medical prosthesis. A thirteen-year experience. J Thorac Cardiovasc Surg. 1994; 108:221-30.
• LaPar DJ, Ailawadi G, Bhamidipati CM, Singh M, Dare D, Kern JA et al. Use of a nonpledgeted suture technique is safe and efficient for aortic valve replacement. J Thorac Cardiovasc Surg. 2011; 141:388-93.
• Jegaden O, Eker A, Delahaye F, Montagna P, Ossette J, Gevigney DG et al. Thromboembolic risk and late survival after mitral valve replacement with the St. Jude Medical valve. Ann Thorac Surg. 1994; 58:1721-8
• Glower DD, White WD, Hatton AC, Smith LR, Young WG, Wolfe WG et al. Determinants of reoperation after 960 valve replacement with Carpentier-Edwars prosthesis. J Thorac Cardiovasc Surg. 1994;107:381- 92.
• Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Sethi GK et al. A comparison of outcomes in men 11 years after heart-vave replacement with bioprosthesis. N Engl J Med. 1993; 328:1289-96. mechanical valve or
• Sezai A, Hata M, Niino T, Yoshitake I, Kasamaki Y, Hirayama A et al. Fifteen years of experience with ATS mechanical heart valve prostheses. J Thorac Cardiovasc Surg. 2010;139:1494-500.
• Goodman SL, Tweden KS, Albrecht RM. Platelet interaction with pyrolytic carbon heart-valve leaflets. J Biomed Mater Res. 1996; 32:249-58.
• Czer LSC, Chaux A, Matloff JM, DeRobertis MA, Nesim SA, Scarlata D et al. Ten year experience with the St. Jude Medical valve for primary valve replacement . J Thorac Cardiovasc Surg. 1990; 100:44-54.
• Şirin HB, Zeybek R, Akçay A, Özbek C, Tonguç E, Dengiz B et al. [Comparison of Medtronic-Hall and St. Jude Medical valve hemodynamic effect on the patient at early postoperative period.] Türk Göğüs Kalp Damar Cer Derg. 1994; 2:260-64.
• Azarnoush K, Laborde F, de Riberolles C. The Sorin Bicarbon over 15 years clinical outcomes: multicentre experience in 1704 patients. Eur J Cardiothorac Surg. 2010; 38:759-66. 17. Demirağ KM, Keçeligil assessment of mitral [Retrospective replacement with St. Jude Medical® mechanical valve prosthesis: Samsun experience.] Türkiye Klinikleri J Cardiovasc Sci. 2006; 18:48-56. valve